44520_DOLAN, MIKE_20060222

1 CAMA / ❑ DREDGE & FILL
GENERAL PERMIT
.-]New ❑Modification ]Complete Reissue ❑Partial Reissue
As authorized by the State of North Carolina, Department of Environment and Natural Resources
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
Applicant Name P P �Iq ✓1 Project Location: County
Address__ t (/`1 k I Street Address/ State Road/ Lot #(s)
City �� C Stat ZIPS
Previous permit #
Date previous perV�iss
A
Phone # ( )
1 a�1 Fax # (/)!!
Subdivision
Authorized Agent
City /- `1? °' '
ZIP--
LiCW
Aw fprTA El ES ❑ PTS
Phone # ( )
River Basin
Affected C OEA
AEC(s):
❑ HHF ElIH ElUBA El N/A
Adj. Wtr. Body —
►" at' man unkn
h PWS:
El FC:
Closest Maj. Wtr. Body
ORW: yes / no
PNA yes / no Crit. Hab. yes / no
Type of Project/ Activity
Pier (dock) length
Platform(s)
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore_
max distance offshore
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
!1
Shoreline Length
SAM not sure yes (no
Sandbags: not sure yes o
Moratorium: n/a yes io
Photos: yes ,fia _
Waiver Attached: yes no JJ
A building permit may be required by: rAt
Notes/ Special Conditions 7 �/� �C 1,4 r
Agent or Applicant Printed Name
- Y l3J
Signature Please read compliance statement on back of permit
Application Fee(s) Check #
(Scale:
❑ See note on back regarding River Basin rules.
i
iy/ Y
Permit Officdr's Signature
Issuing Date f Elpiratigh Date
C,r �„.-,.I C
Local Planning Jurisdiction
Rover File Name

Statement of Compliance and Consistency
This permit is subject to compliance with this application, site drawing and attached general and specific conditions. Any
violation of these terms may subject the permittee to a fine or criminal or civil action; and may cause the permit to become
null and void.
This permit must be on the project site and accessible to the permit officer when the project is inspected for compliance. The
applicant certifies by signing this permit that 1) prior to undertaking any activities authorized by this permit, the applicant will
confer with appropriate local authorities to confirm that this project is consistent with the local land use plan and all local
ordinances, and 2) a written statement or certified mail return receipt has been obtained from the adjacent riparian
landowner(s) .
The State of North Carolina and the Division of Coastal Management, in issuing this permit under the best available
information and belief, certifythatthis project is consistentwith the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
❑ Tar - Pamlico River Basin Buffer Rules ❑ Other:
❑ Neuse River Basin Buffer Rules
If indicated on front of permit, your project is subject to the Environmental Management Commission's Buffer Rules for the
River Basin checked above due to its location within that River Basin. These buffer rules are enforced by the NC Division of
Water Quality. Contact the Division of Water Quality at the Washington Regional Office (252-946-6481) or the Wilmington
Regional Office (910-796-7215) for more information on how to comply with these buffer rules.
Division of Coastal Management Offices
Central Office Elizabeth City District
Mailing Address: 1367 U.S. 17 South
1638 Mail Service Center Elizabeth City, NC 27909
Raleigh, NC 27699-1638 252-264-3901
Location: Fax: [phone]
Parker -Lincoln Building
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293
Fax: [phone]
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquotank and Perquimans
Counties)
Morehead City District
400 Commerce Ave
Morehead City, NC 28557
202-808-2808/ 1-888-4RCOAST
Fax: [phone]
(Serves: Carteret, Craven, Onslow -above
New River Inlet- and Pamlico Counties)
Washington District
943 Washington Square Mall
Washington, NC 27889
252-946-6481
Fax: [phone]
(Serves: Beaufort, Bertie, Hertford, Hyde,
Tyrrell and Washington Counties)
Wilmington District
127 Cardinal Drive Ext.
Wilmington, NC 28405-3845
910-796-7215
Fax: [phone]
(Serves: Brunswick, New Hanover,
Onslow -below New River Inlet- and
Pender Counties)
Revised 06/29/05

FEB 2
o YN_�- S T'_�:i�ltt�".�*�I`�+A-
- �.f10F
FOR A_ _P.IER117NCOVEPF'D B0A7.I,II7j Morehead city aCM
hereby certify [hat I OWN property adjacent to � r�q -�J (ter j _
1 �dirlie of Property O) Iler-)
prnperty located at bwdl Ifkf r In ciur �/�,t
i.ot, Black, Ruad, etc.) --------- ---
of] "r+
---(Waterbody) - -- — --- — --
(To iv-n and./ orb (�ounty)
He has desc-ibed to me, as shown belo'�-, the deve!opf;ient he is proposing at that
lcxcation, and, I have no objections to his proposal. I undersiand rhar a pier/uncovered boat Lir
must be set Sack a minimum distance, of rlt-Leta fe--t (15') ttorn my area of riparian access unless
waived by me.
I do not wish to waive.the setback requirement.
I do wish to waive that setback requirement.
- ---------------------------------------------
DESCRIY'ITON A-`ID/OR DRAWING OF PROPOSED DE%ELOP'v.CE..NT:
(To be filled in by T/I�LYZdllClj y�yoSal2,.^ .�?`,'eIl t
,, pin eltt)
------------------------------------------------- -
Signature
Pr-inc or 1 yp-2 N.Wie
Z 5 Z — ZL-Q--- 3 e-e - --
T�-lc.phone Nuuib,; r
i
Date: 2—

ADJACEN ` ►_ Jttiiv i nr 1� x
�` o tiv�v _;� `� -3 ;
-OR A PIEFJUNCOV— fiD �Ofl7' 1�II7) �2
I hereby c4rLify that I own property adjacent to � � r� a�•
D'
of Proper-ty (�ti�ne CM
property located at
- (Lot, Black, Road, etc.)
on �54 In C,
(Waterbody) (Toz aud;,) ounty)
He has desc-ibed to me, as shou.ri below, the devc!cpr,tent he is proposi.n; at tt:at
location, and, I have no obje~ Lions to his proaosal. I understl.nd (iliac a pier/uncovered boat lir
must be set Sack a minimum distance oC rifte--n fit (15') from my area of riparian ac; ass unless
waived by me.
i
I do not wish to waive .the sc back requirement.
j I do wish to waive that setback requirement.
----------- --------------- ------------------
i DESCRLPTI(DN A—ND/OR DRAWRiG OF PROPOSE)DEVELOPNI—N-T:
(To be Puled in be v-iduc-1 pmpo.^:n ue. el�,p�nent)
i
3<
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---------------------------------- ------------------------------------------------ (_-------------------------------
Signature
GU ��, a �,_.,_a►�� __
Print or Typ-2 N'.1dne
Telephone Nurill-J,r
i
Date: V i� / Q

P.111.)FE11,TY 0 �VNft.
ATOR A PIEFICINCO VER—ED BOA TI+IFT)
Q
I hereby u![,-ify that f own prop--rty ad'acctit to j
W
property lcx-aled at G��W �O_VA r— ko"r
(Lot, Black, ROR r3I etc.)
-
onQft IJ in
C
(Vy'aterbody) -n and/brIC-Ounty)
(Tow
He has descri
bed to me, asshown below, the devc!cpfieni he. is propo-Suii,, at Lhat
loc_a6ori, and, I have no objecttions to his proposal. I undersuand i;har a pier/uncovered boat lift
must be set Sack a minimum distanceiriparian acc�:!_-,s unless
or Mrtctn fc-_ct (15') from myarea o( ,
waived by me.
I do not wish to waive the setback reQuilUMMIL.
I do wish to waive that setback requirement.
---------------------------------- -------------------------------------------------------------- — ------------------
DESCR=ON A_N-D/OR DRAWS OF PROPOSED DEVELOP-NLEMNT:
(To be)! eci in by ihdiv&ut-J prr.Fos-,*ng devellrIpm erzt)
I
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Signature
Print or I I
5417 --- �52- 726- T�Icphone N!Amb,17
A,D 6

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